Comparison of burned patients\u27 perception of pain with nurses\u27 perception of patients\u27 pain

Pain is a universal experience. Caring for people in pain is a central aspect of nursing practice. Many studies have been done to determine the physical and psychosocial mechanisms of the pain sensation, in addition to methods of relief. Very little has been done, however, dealing specifically with the pain experienced by the burned patient. People hospitalized with thermal injuries complain most often of the intensity and long duration of their pain experience. Due to the large number of persons sustaining thermal injuries every year, it is apparent that nurses must familiarize themselves with methods of evaluation and intervention to reduce or eliminate pain. More importantly, they must be aware of how they are perceiving the burned patient\u27s pain at any given time, and whether this is congruent with the patient\u27s perception of his or her pain

The role of staging bronchoscopy in the preoperative assessment of a solitary pulmonary nodule.

In order to assess the role of a staging fiberoptic bronchoscopy in the preoperative assessment of an indeterminate solitary pulmonary nodule (SPN), we reviewed our experience in 33 SPNs identified among 1,269 bronchoscopies performed at the Albert Einstein Medical Center between 1985 and 1989. All lesions were less than 4 cm in greatest diameter and were not associated with symptoms of weight loss, chest pain, hemoptysis, localized wheezing, or hoarseness. A tissue diagnosis was established in 25 patients, 23 of whom had a malignant SPN. This study failed to detect a single case in which a fiberoptic bronchoscopic examination of the airway discovered a lesion that would preclude surgery and potentially curative resection. We recommend the abandonment of a staging bronchoscopy in the evaluation of a patient with an indeterminant SPN in whom history, physical examination, laboratory, and imaging studies fail to document contraindications to surgery. No additional useful information is derived and a substantial cost savings to the patient can be realized if the procedure is eliminated